Are US Jurisdictions Prepared to Dispense Medical Countermeasures Through Open Points of Dispensing? Findings from a National Study

Abstract

Communities will rely on open points of dispensing (PODs) for mass dispensing of medical countermeasures following a bioterrorism attack or a pandemic. US Cities Readiness Initiative (CRI) open POD preparedness is assessed using the Technical Assistance Review (TAR) but focuses on oral prophylaxis dispensing; mass vaccination readiness is not well measured. Non-CRI preparedness had not been studied. In 2013 an online questionnaire was sent to all 456 CRIs and a random sample of 500 non-CRIs to measure open POD preparedness and exercise participation. Hierarchical linear regression was used to describe factors associated with higher POD preparedness and exercise participation scores. In total, 257 subjects participated, for a 41% response rate. Almost all open PODs have existing written plans and/or a layout for each site (93.4%, n=240, and 87.0%, n=220). Only half (46.7%, n=120) have an alternative dispensing modality in place, and even fewer (42.6%, n=104) report having adequate staffing. Determinants of open POD preparedness were perceived preparedness, participation in more POD exercises, and more closed POD coverage. Most jurisdictions conducted a full-scale exercise and a staff notification drill (83.7%, n=215 for both). Fewer than half (40.5%, n=104) have conducted a vaccination clinic exercise. Determinants of increased POD exercises were perceived preparedness, years of work experience, community type (nontribal), and larger population. Because successful open POD deployment is critical, jurisdictions need to plan for mass vaccination, use of alternative dispensing modalities, and recruitment strategies to increase POD staffing.

Recommendations on How to Manage Anticipated Communication Dilemmas Involving Medical Countermeasures in an Emergency

“…For example, researchers help uncover promising MCM products; pharmaceutical and biotechnology companies develop and manufacture various MCMs; and state, local, tribal, and territorial governments, public health systems, and nongovernmental partners plan jointly for mass distribution and dispensing. 3 –7…”

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Cov-2) and the COVID-19 Pandemic: The Early Months

“…There will also be a need for the rapid dispensing of vaccine once one has been developed. This may include the use of open and closed points of dispensing (PODs) for mass vaccination efforts [44]. Hospitals function as closed PODs, so acute care nurses should be able to receive COVID-19 vaccine on-site once the vaccine is available.…”

“…Many other healthcare settings, such as long-term care facilities and outpatient surgery centers often serve as closed PODs, so nurses working in those settings should also have rapid access to vaccine. For nurses who work in agencies that are not closed POD sites, vaccine will be made available through open POD sites that are available to citizens in all jurisdictions that plan to use PODs for mass vaccination [44,45]. Due to the current lack of pharmacological interventions, non-pharmacological interventions (NPIs), such as surveillance, isolation, contract tracing, and social distancing are the most effective ways to control COVID-19 at this time.…”

Current State of Mass Vaccination Preparedness and Operational Challenges in the United States, 2018-2019

“…Multiple efforts-including the Trust for America's Health Ready or Not report, 13 the National Health Security Preparedness Index, 14 and 2 peer-reviewed studies 15,16 -have examined at an aggregate level state and local health departments' abilities to dispense MCMs; however, they have not specifically examined the capacities to conduct mass vaccination operations during public health emergencies, including pandemics. Additionally, studies that address MCM dispensing often lack a clear distinction between the operational needs of mass vaccination versus pill dispensing, [17][18][19] report on experiences of a single population or jurisdiction, [20][21][22][23] and/or discuss mass vaccination during smaller-scale outbreaks or in nonemergency settings. 24,25 Considering the dearth of assessments of mass vaccination operations or US readiness to conduct mass vaccination, and the long-standing focus on anthrax and pill-based MCM dispensing modalities, we interviewed jurisdictional representatives to understand their experiences preparing for or conducting mass vaccination.…”